DefinitionThe age-adjusted drug-induced mortality rate is defined as the number of deaths attributed to drugs per 100,000 population. The list of codes included in drug-induced causes was expanded in the 2003 data year to be more comprehensive. The following ICD-10 codes comprise the list of drug-induced codes: D52.1, D59.0, D59.2, D61.1, D64.2, E06.4, E16.0, E23.1, E24.2, E27.3, E66.1, F11.1-F11.5, F11.7-F11.9, F12.1-F12.5, F12.7-F12.9, F13.1-F13.5, F13.7-F13.9, F14.1-F14.5, F14.7-F14.9, F15.1-F15.5, F15.7-F15.9, F16.1-F16.5, F16.7-F16.9, F17.3-F17.5, F17.7-F17.9, F18.1-F18.5, F18.7-F18.9, F19.1-F19.5, F19.7-F19.9, G21.1,G24.0, G25.1, G25.4, G25.6, G44.4, G62.0, G72.0, I95.2, J70.2-J70.4, K85.3, L10.5, L27.0, L27.1, M10.2, M32.0, M80.4, M81.4, M83.5, M87.1, R78.1, R78.2, R78.3, R78.4, R78.5, X40-X44, X60-X64, X85, and Y10-Y14.
NumeratorNumber of deaths induced by drugs in the resident population for a specific time period.
DenominatorMid-year resident population for the same period, expressed as a rate per 100,000 for a specific time period.
Data Interpretation Issues[http://live.laborstats.alaska.gov/pop/index.cfm Alaska population estimates] provided by the State Demographer in the [http://laborstats.alaska.gov/ Research and Analysis Section] of the [http://labor.alaska.gov/ Alaska Department of Labor and Workforce Development].
The list of ICD-10 codes with descriptions for drug-induced mortality can be found in the National Vital Statistics Reports, [https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf Deaths: Final Data for 2016].
Why Is This Important?Alcohol and substance misuse have a devastating impact on individuals, families and entire communities across Alaska. The effects of alcohol and other drug misuse include unintentional and intentional injuries, violence, high-risk sexual behaviors, cirrhosis, and alcohol poisoning.^2,3^ Alaska experiences a disparately high rate of alcohol-induced mortality compared to the U.S.^4^ Alcohol and other drug use is common among adolescents and is a strong predictor of dependence in later life.^5^
2. World Health Organization. Interpersonal violence and illicit drugs. [https://www.who.int/violenceprevention/interpersonal_violence_and_illicit_drug_use.pdf]. Accessed February 20, 2019.
3. World Health Organization. Global status report on alcohol and health 2018. [https://www.who.int/substance_abuse/publications/global_alcohol_report/gsr_2018/en/]. Accessed February 20, 2019.
4. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States. Prev Chronic Dis 2014;11:130293.[http://dx.doi.org/10.5888/pcd11.130293]. Accessed February 19, 2019.
5. National Institute on Drug Abuse. Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide. Updated June 2014. [https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/introduction]. Accessed February 19, 2019.
Healthy People Objective: Reduce drug-induced deathsU.S. Target: 11.3 deaths per 100,000 population
How Are We Doing?In 2018, drug-induced deaths claimed the lives of 118 Alaskans, an age-adjusted rate of 15.7 deaths per 100,000. A 25.9% decrease since 2017.
During 2004-2018, adults 25-34, 35-44 years old and 45-54 years old experienced the highest rates of drug-induced mortality at 23.4, 27.3, and 28.7 per 100,000, respectively. Rates of drug-induced mortality by region were lowest in the Northern region (7.6 per 100,000).
How Do We Compare With the U.S.?In 2017 (the most recent year for which national data are available), the national rate of drug-induced mortality was 21.7 per 100,000.^6^ The 2017 rate for all Alaskans was 21.2 per 100,000 and 36.7 per 100,000 for Alaska Native people.[[br]]
6. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2017 on CDC WONDER Online Database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999-2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Oct 3, 2019.}}
What Is Being Done?Many illicit drugs are of public health concern in Alaska.^7^ In February 2017, Governor Bill Walker declared a public health crisis in response to the dramatic increase in heroin and opioid misuse in the state.^8^ The disaster declaration established a statewide [http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/narcan.aspx Overdose Response Program] and allows for the distribution of Naloxone, a lifesaving drug that can reverse overdoses caused by opioids.^8^ Although Naloxone would not be effective against an overdose on cocaine, the disaster declaration was also accompanied by the signing of Administrative Order 283. The order instructs all state departments to apply for federal funding for drug abuse prevention and treatment options, the elimination of illegally imported drugs into the state, and the development of resources to provide medical treatment to drug users.^8^[[br]]
7. Hull-Jilly DMC, Casto LD. State Epidemiologic Profile on Substance Use, Abuse, and Dependency--2007-2011. Alaska Department of Health and Social Services. Released November 7, 2013.
8. State of Alaska, Office of the Governor. Safer Alaska: Building Stronger Communities. 16 May 2017. Available at https://gov.alaska.gov/administration-focus/safer-alaska/, Accessed May 17, 2017.
Evidence-based PracticesSAMHSA maintains a website that collects the latest in substance abuse prevention evidence based practices. The link to the information can be found here [http://www.samhsa.gov/ebp-web-guide/substance-abuse-prevention]
Health Program InformationThe State of Alaska Epidemiologic Profile on Substance Use, Abuse and Dependency is available at: [http://dhss.alaska.gov/dph/Epi/injury/Documents/sa/SubstanceAbuseEpiProfile_2013.pdf]. This profile provides a more detailed report on the state of substance use and abuse in Alaska.
The State of Alaska also provides websites on opioid use through Health and Social Services. Please use the following links to access more information about the misuse of opioids, much of which is applicable to other substances of abuse: [http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/default.aspx].